Update on treatment as prevention of HIV illness, death, and transmission: sub-Saharan Africa HIV financing and progress towards the 95–95–95 target
Purpose of review
After over 40 years, the HIV pandemic is amongst the deadliest in history – 100% fatal without treatment, HIV has infected over 84 million people, and has caused over 40 million deaths. Global HIV spending between 2000 and 2015 totaled over a half trillion dollars. Delays in harnessing scientific advances, including ‘test and treat’ and treatment as prevention of illness, death, and transmission (TasP) provide a cautionary tale applicable to other pandemics. Resource allocation has also been problematic with many highest burden countries spending less than 50% on care and treatment.
Recent ...
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: SPECIAL COMMENTARIES Source Type: research
Causes and outcomes of hepatic fibrosis in persons living with HIV
Purpose of review
The epidemiology of liver disease in people living with HIV has evolved since the arrival of effective hepatitis C virus (HCV) treatment. Nonalcoholic fatty liver disease (NAFLD) in HIV patients is highly prevalent while hepatitis D, hepatitis E, and occult hepatitis B remain underappreciated. We discuss mechanisms of fibrosis in HIV and review clinical outcomes of HIV-associated liver diseases.
Recent findings
HIV-HCV co-infection is receding as a cause of progressive liver disease, but fibrosis biomarkers after HCV treatment remain elevated. Antiretroviral therapy (ART) with anti-hepatitis B ...
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: SPECIAL COMMENTARIES Source Type: research
A calculated risk: Evaluating HIV resistance to the broadly neutralising antibodies10-1074 and 3BNC117
Purpose of this review
Broadly neutralising antibodies (bNAbs) are a promising new therapy for the treatment of HIV infection. However, the effective use of bNAbs is impacted by the presence of preexisting virological resistance and the potential to develop new resistance during treatment. With several bNAb clinical trials underway, sensitive and scalable assays are needed to screen for resistance. This review summarises the data on resistance from published clinical trials using the bNAbs 10-1074 and 3BNC117 and evaluates current approaches for detecting bNAb sensitivity as well as their limitations.
Recent finding...
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: THERAPEUTIC VACCINES: Edited by Beatriz Mothe Source Type: research
Challenges of HIV therapeutic vaccines clinical trials design
Purpose of the review
To discuss main challenges of therapeutic vaccine clinical trials design, implementation and analyses in the HIV cure field.
Recent findings
Therapeutic vaccines are progressively being postulated as T-cell stimulating agents to use in combination HIV cure strategies, with the addition of immunomodulators, latency reversing agents and/or broadly neutralizing antibodies. Although promising strategies are rapidly evolving in preclinical studies using nonhuman primate models, translation into human testing in randomized controlled clinical trials is more challenging and expensive to conduct. A...
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: THERAPEUTIC VACCINES: Edited by Beatriz Mothe Source Type: research
New vector and vaccine platforms: mRNA, DNA, viral vectors
Purpose of review
The purpose of this review is to share the excitement of new developments in the field of vaccine vector modalities against infectious diseases. The focus is on HIV-1/AIDS with reference to the most successful as well as currently tested COVID-19 vaccines, and human trials, which best inform iterative vaccine improvements.
Recent findings
Several genetic subunit vaccines against SARS-CoV-2 demonstrated protection against severe disease, obtained Emergency Use Authorization and scaled their production to billions of doses. Many more are in efficacy evaluation. In contrast, development of HIV-1 v...
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: THERAPEUTIC VACCINES: Edited by Beatriz Mothe Source Type: research
HIV T-cell immunogen design and delivery
Purpose of the review
Not all T-cell responses against HIV are created equally and responses of certain epitope specificities have been associated with superior control of infection. These insights have spurred the development of a wide range of immunogen sequences, each with particular advantages and limitations.
Recent findings
We review some of the most advanced designs that have reached or are close to reaching human clinical trials, with a special focus on T-cell immunogen developed for therapeutic use. We also touch upon the importance of how immunogens are delivered and point out the lamentable fact that ...
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: THERAPEUTIC VACCINES: Edited by Beatriz Mothe Source Type: research
Editorial introduction
No abstract available (Source: Current Opinion in HIV and AIDS)
Source: Current Opinion in HIV and AIDS - October 4, 2022 Category: Infectious Diseases Tags: EDITORIAL INTRODUCTION Source Type: research
Elite and posttreatment controllers, two facets of HIV control
Purpose of review
The quest for HIV-1 cure could take advantage of the study of rare individuals that control viral replication spontaneously (elite controllers) or after an initial course of antiretroviral therapy (posttreatment controllers, PTCs). In this review, we will compare back-to-back the immunological and virological features underlying viral suppression in elite controllers and PTCs, and explore their possible contributions to the HIV-1 cure research.
Recent findings
HIV-1 control in elite controllers shows hallmarks of an effective antiviral response, favored by genetic background and possibly associ...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CONTROLLERS AND NATURAL CURES: Edited by Matthieu Perreau Source Type: research
CD8+ T-cell responses in HIV controllers: potential implications for novel HIV remission strategies
Purpose of review
Immunological studies of spontaneous HIV and simian virus (SIV) controllers have identified virus-specific CD8+ T cells as a key immune mechanism of viral control. The purpose of this review is to consider how knowledge about the mechanisms that are associated with CD8+ T cell control of HIV/SIV in natural infection can be harnessed in HIV remission strategies.
Recent findings
We discuss characteristics of CD8+ T-cell responses that may be critical for suppressing HIV replication in spontaneous controllers comprising HIV antigen recognition including specific human leukocyte antigen types...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CONTROLLERS AND NATURAL CURES: Edited by Matthieu Perreau Source Type: research
Effective innate immune response in natural HIV-1 controllers. Can mimicking lead to novel preventive and cure strategies against HIV-1?
Purpose of review
HIV-1 controller individuals represents a model that can be useful for the development of novel vaccines and therapies. Initial studies pointed to the involvement of improved adaptive immunity, however, new emerging evidence suggests the contribution of innate cells to effective antiviral responses in spontaneous controllers. Therefore, understanding the alterations on innate cell subsets might be crucial to develop new effective therapeutic strategies.
Recent findings
Among different innate immune cells, dendritic cell (DC) and natural killer (NK) cell are essential for effective antiviral res...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CONTROLLERS AND NATURAL CURES: Edited by Matthieu Perreau Source Type: research
Towards a molecular profile of antiretroviral therapy-free HIV remission
Purpose of review
To summarize the current status and highlight recent findings on predictive biomarkers for posttreatment HIV control (PTC) and virological remission. While historically, many studies focused on virological markers, there is an increasing tendency to enter immune and metabolic factors into the equation.
Recent findings
On the virological side, several groups reported that cell-associated HIV RNA could predict time to viral rebound. Recent data hints at the possible importance of the genic location and chromatin context of the integrated provirus, although these factors still need to be assessed ...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CONTROLLERS AND NATURAL CURES: Edited by Matthieu Perreau Source Type: research
Statins for primary cardiovascular disease prevention among people with HIV: emergent directions
Purpose of review
While people with HIV (PWH) are living longer due to advances in antiretroviral therapy, recent data have demonstrated an increased risk of cardiovascular disease (CVD) among this population. This increased risk is thought to be due to both traditional (for example, smoking, diabetes) and HIV-specific (for example, inflammation, persistent immune activation) risk factors. This review focuses on the potential for statin therapy to mitigate this increased risk.
Recent findings
Several randomized clinical trials have demonstrated that statins, a class of lipid-lowering medications, are effective a...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE: Edited by Virginia A. Triant Source Type: research
HIV and cardiovascular disease: the role of inflammation
Purpose of review
HIV and antiretroviral therapy (ART) use are linked to an increased incidence of atherosclerotic cardiovascular disease (ASCVD). Immune activation persists in ART-treated people with HIV (PWH), and markers of inflammation (i.e. IL-6, C-reactive protein) predict mortality in this population. This review discusses underlying mechanisms that likely contribute to inflammation and the development of ASCVD in PWH.
Recent findings
Persistent inflammation contributes to accelerated ASCVD in HIV and several new insights into the underlying immunologic mechanisms of chronic inflammation in PWH have been ...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE: Edited by Virginia A. Triant Source Type: research
Addressing gaps in cardiovascular care for people with HIV: bridging scientific evidence and practice
Purpose of review
People with HIV continue to have an excess burden of cardiovascular disease compared to the general population. The reasons for these disparities in cardiovascular disease include HIV-specific risk enhancers, traditional atherosclerotic cardiovascular disease risk factors, and sociodemographic disparities, all of which are ripe targets for intervention.
Recent findings
Accurate risk prediction of atherosclerotic cardiovascular disease remains difficult, and cardiovascular risk for people with HIV may be underestimated in the absence of HIV-specific risk enhancers. Despite this increased cardiov...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE: Edited by Virginia A. Triant Source Type: research
Cardiovascular disease risk in women living with HIV
Purpose of review
To synthesize current evidence on the impact of cardiovascular disease among women living with HIV (WLWH) with a particular focus on disease prevalence, mechanisms and prevention.
Recent findings
HIV-related cardiovascular disease risk is 1.5-fold to 2-fold higher for women than for men. Mechanisms of enhanced risk are multifactorial and include reinforcing pathways between traditional risk factors, metabolic dysregulation, early reproductive aging and chronic immune activation. These pathways influence both the presentation of overt syndromes of myocardial infarction, stroke and heart failure,...
Source: Current Opinion in HIV and AIDS - August 18, 2022 Category: Infectious Diseases Tags: CARDIOVASCULAR DISEASE: Edited by Virginia A. Triant Source Type: research
